The blistering, 81-page report released earlier today blamed shoddy paperwork for most of the improper payments in the Medicaid Home Help Program.

(Detroit Free Press) -- The State of Michigan improperly paid $160 million in a 29-month period for services provided to vulnerable, low-income adults in a program designed to keep them out of more expensive, long-term care, according to a report released earlier today by the state's Auditor General.

Among those on the payroll: convicted criminals — including those convicted of crimes ranging from financial fraud to homicide, auditors found.

The blistering, 81-page report released earlier today blamed shoddy paperwork for most of the improper payments in the Medicaid Home Help Program, A son or daughter with a rap sheet may be the best person to help care for a bed-bound parent, for example.

But others may be strangers to the vulnerable clients.

The blistering, 81-page report released earlier today blamed shoddy paperwork for most of the improper payments in the Medicaid Home Help Program, but it also noted a lack of oversight and follow-through when staff could have identified and corrected problems.

The program, funded by state and federal dollars, provides personal care services to more than 66,000 clients with medical needs. Home help providers help with light housekeeping, laundry, toileting, personal care and other activities of daily life.

The agencies responsible — Michigan's Departments of Community Health and Human Services — already have taken steps to correct some of the problems, the report said.

Maura Corrigan, director of the Department of Human Services, said she hadn't realized the "scope" of the problems until auditors began poring through records and talking to staff.

■ The state's community health and human services departments failed to obtain sufficient or timely paperwork to ensure $146.4 million in services were adequate and clients were satisfied during a 29-month period ending February 2013. That money represents $49.6 million from the state's general fund. Every dollar spent in state money leverages about two more in federal funds.

■ At least $3.3 million in services were provided to individuals that did not qualify for them.

■ Workers included 3,786 with felony convictions — including 572 with violent convictions from assault to homicide and 285 for sex crimes. Another 1,148 workers had been convicted of fraud, identity theft and other financial crimes.

The program differs from a traditional home health program in which trained medical staff provide care through an agency. In this case, family members or others are paid to care for the disabled or elderly adult, who are also poor. Usually that pay is a "few hundred dollars" a month compared to thousands of dollars in a nursing home, for example.

The report Tuesday isn't the first indication of problems.

In January, Michigan Attorney General Bill Schuette announced charges in 17 cases involving Home Help. Six cases have resulted in convictions, including five in which providers continued to receive payments after the clients had died. In a sixth case, the provider had been sent to prison, but his client — his girlfriend — continued to cash his checks.

Neither federal nor state law requires criminal history checks of these caregivers, according to the auditor's report. And convictions under state law do not preclude payments to a provider, said Corrigan at DHS.